Young adolescents living in the liminal space of cancer: A narrative inquiry study

BackgroundA cancer diagnosis changes how adolescents view their world as they confront the reality of side effects from cancer-related treatment, loss, changes to their usual routines, and feeling isolated. The cancer experience of adolescents has been studied previously. However, little is known about the young adolescent’s experience of cancer.AimTo explore young adolescents’ (11–15 years) experience during the first year of their diagnosis.MethodsA qualitative narrative inquiry was undertaken. Interviews were conducted with 11 young adolescents in the first 3–6 weeks after a cancer diagnosis. Clandinin’s conceptual framework of the three dimensions of narrative inquiry (Sociality, Temporality, and Place) was used to analyse the data.FindingsThree interrelated threads were revealed: (1) confronting cancer, loss, and altered embodiment; (2) feeling stuck in time and place (a liminal space); (3) staying connected across time and changing landscapes.DiscussionInsights revealed the challenges for young adolescents as they navigated the expected physical and social developmental norms when diagnosed with cancer. Young adolescents with cancer appear to experience being constrained in a dual liminal space as they transition from childhood to being an older adolescent.ConclusionsThese findings illustrate liminality related to the experience of cancer for this group in the context of the dimensions of Clandinin and Connelly’s framework: Sociality, Temporality, and Spatiality. The unique needs of young adolescents were identified in this study.     

The adolescent’s experience of cancer: An integrative literature review

AimThis integrative review appraises the literature that explores the experiences of the adolescent diagnosed with cancer.BackgroundThe cancer experience has an impact on the way the adolescent lives their life, their future hopes dreams and fears, their health and wellbeing. Healthcare professionals require an understanding of what the adolescent experiences after a diagnosis of cancer and during the treatment experience to be able to provide optimal age appropriate care.MethodsThe review was conducted following Whittemore and Knafl’s (2005) framework. A comprehensive search using the following four databases, CINAHL, MEDLINE, PyschINFO, Embase was undertaken for the period of 2005–2016. Google scholar, healthcare policies and guidelines reference lists were also searched. Screening and appraisal of 911 articles resulted in 22 articles being included in this review.FindingsThree themes were identified: ‘Losing what I know - this is what makes me different’, ‘Communication and information sharing - the need to know’, and ‘The importance of friends, peers and relationships’.ConclusionThis review reports that healthcare providers should be aware of the changing self-perceptions the adolescent experiences throughout the cancer journey. Accessing this information will enable healthcare providers to determine more appropriate care when these adolescents are feeling most vulnerable. The review identified there is limited information about the experience of the younger adolescent (11–15 years) with cancer. Future research may benefit from focusing on the stage of development of the adolescent with cancer.     

Living with breast cancer: Iranian women's lived experiences

JOULAEE A., JOOLAEE S., KADIVAR M. & HAJIBABAEE F. (2012) Living with breast cancer: Iranian women's lived experiences. International Nursing Review59, 362-368 Background: Breast cancer is the most common form of cancer among women. Women with breast cancer encounter many psychosocial stresses as well as physical problems. Aim: To capture the meaning of living with breast cancer from the unique perspective and through the lived experiences of Iranian women with breast cancer that were explained with their own words. Methods: A phenomenological approach was used to explore the meaning of living with breast cancer for Iranian women. The patients' feelings and lived experiences with breast cancer were investigated using semi-structured interviews with probing questions with 13 women between 34 and 67 years old. Findings: The participants explained their experiences of living with breast cancer as losing something important, lack of confidence, living with fear, emotional dizziness and the need to be supported with the negative aspects of breast cancer and helped to explore new aspects of life as positive aspects of this event. Conclusion and Implications: Understanding the phenomenon of 'living with breast cancer' seems to be crucial for nurses to help women with breast cancer to find themselves in confronting the consequences of the changes associated with the illness.     

乳腺癌患者人文关怀体验的质性研究

目的：深入了解与探讨乳腺癌患者对护士的人文关怀行为的体验和感受。方法采用质性研究的现象学研究方法,收集经历3次住院的20例乳腺癌患者,并运用Colaizzi分析程序分析法对其进行分析。结果得到的主题为：心怀同理,尊重体谅;责任感化为服务,耐心细致;有鼓励,未来有希望;关怀中展现专业素养;全方位帮助和支持。结论对乳腺癌患者实施人文关怀护理,使患者与护士从精神及人格上都得到了提升,让乳腺癌患者在生命的艰难历程中感受到温暖和关怀,鼓励患者勇于挑战疾病,有效提高了患者的生命质量。     

心灵关怀对癌症患者焦虑、抑郁情绪的影响

目的:探讨心灵关怀对癌症患者焦虑、抑郁情绪的影响.方法:将120例新入院癌症患者随机分为对照组和实验组各60例,对照组采用常规护理、健康教育;实验组采用在此基础上辅以心灵关怀;分别于入院时、出院前对两组采用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行测评,并观察两组效果.结果:出院时两组SAS测评分别43.3%和75.0%,SDS测评分别48.3%和70.2%,实验组显著低于对照组(P＜0.01).结论:心灵关怀通过减轻癌症患者的心理压力、对疾病诊断、治疗产生的不确定感、疼痛和症状困扰等不适,有效减轻癌症患者焦虑、抑郁情绪.     

中老年癌痛患者灵性需求与睡眠质量状况及相互关系

目的 了解中老年癌痛患者灵性需求与睡眠质量的状况,并分析二者之间的相关性,为灵性护理干预提供依据.方法 选取2019年5—11月福建省某三级甲等医院收治的132例中老年癌痛患者为研究对象,采用一般资料调查表、中文版灵性需求评估量表(SNS)及匹兹堡睡眠质量指数量表(PSQI)进行调查,并对灵性需求与睡眠质量相关性进行分...     

Developmental diversity in symptom research involving children and adolescents with cancer

The purpose of this literature review was to evaluate developmental diversity in studies describing physical symptoms in children and adolescents receiving cancer treatment. Developmental diversity was conceptualized as individual differences based on normal stages of human development, including cognitive, psychosocial, and physiologic aspects. Searches of Medline and the Cumulative Index of Nursing and Allied Health Literature identified 53 articles published between January 1986 and November 2006. Most studies addressed symptoms in school-aged children and adolescents; few compared symptoms across age groups. Additional measures are needed to describe younger children's symptoms. Alternate research methodologies may be appropriate to describe their symptom experiences.     

The experience and challenges of rural persons with cancer and their families

ObjectiveApproximately 30% of the population of Australia live over 180 km from tertiary healthcare facilities. In rural areas there are fewer health resources and greater travelling distances for treatment. Family support for health care or illness prevention can either be strengthened or disrupted in times of need, yet family is a key aspect of the person’s supportive network. This research sought to understand the experiences and challenges for persons with cancer and their families from rural Queensland.DesignA qualitative study used 14 telephone interviews involving eight persons with cancer and six family members to understand their experience when travel for treatment was required.SettingRural Queensland, Australia.ParticipantsPersons with cancer and family who stayed in Cancer Council Queensland Accommodation.ResultsThree themes developed; confronting diagnosis, challenges, and negotiating support.ConclusionsChallenges included travel concerns and lack of services at home; however, family support and appreciating positive aspects were highlighted as part of the experience. This research identified a need for tailored support, which recognises their rurality. Open communication with health professionals helps identify specific needs and service barriers.     

Hope as experienced in women newly diagnosed with gynaecological cancer

AimThis article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer.MethodFifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24–87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer.ResultsHope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others.ConclusionThe findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.     

前列腺癌患者疾病体验质性研究的Meta整合

目的 系统评价前列腺癌患者疾病体验的质性研究,为提高该人群心理健康和建立支持体系提供参考.方法 检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中收录的关于前列腺癌患者患病体验的质性研究,检索时限从建库至2021年4...     

Suicide in adolescents with depression: the need for early diagnosis

Adolescent suicide is a public health problem worldwide. Parents and family play a crucial role in seeking professional help early enough to avoid catastrophic outcomes such as the death of a teenager.     

The experience of cancer cachexia: A qualitative study of advanced cancer patients and their family members

Background

Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective

The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design

An interpretative phenomenological approach was employed.

Setting and participants

A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method

Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results

Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions

Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.     

'Being in the same boat': ethnographic insights into an adolescent cancer unit

Cancer may be considered a particularly challenging diagnosis for adolescents. Treatment for adolescents in the United Kingdom may be provided in paediatric or adult settings or, more rarely, in specialist adolescent cancer units. An ethnographic approach was adopted to gather ‘insiders’ views of one such unit using in-depth interviews with patients, parents and professionals, as well as non-participant observation of key events. Two data themes ‘cancer and the cancer unit’ and ‘changes over time’ are discussed in this paper. Benefits of the unit included shared understandings and the manner in which the privations of adolescent cancer were contained and managed by those involved.     

Evaluating depression in a sample of children and adolescents with cancer in Greece

Background:  Several studies have found that serious illness increases the risk of depression. One of the most common psychiatric disorders related to the diagnosis and treatment of cancer is depression.
Aim:  The aim of the present study was to investigate the rate of depression in children with cancer compared with that in healthy children.
Patients and methods:  The present study is an ongoing prospective study. The research group consisted of 80 children with cancer followed up by an oncology inpatient clinic of a Greek Children's hospital. The control group consisted of 84 healthy children. After parental consent was obtained, data were collected using the Children's Depression Inventory (CDI) and a socio-demographic data form.
Results:  At the time that this study was carried out, neither the research group nor the control group suffered from depression. In particular, there was no statistically significant difference between the two groups with respect to symptoms of depression (  = 5.88 for children with cancer vs.  = 7.23 for healthy children, U  = 3013, P  = 0.25).
Conclusions:  Our findings suggest that the children in this study with malignancies did not have higher depression scores than their healthy peers, although many previous surveys confirm that children with cancer are at high risk for depression.     

米氮平治疗青少年抑郁症的开放性研究

目的 探讨米氮平治疗青少年抑郁症的临床疗效和安全性。 方法 对32例符合《中国精神疾病分类方案与诊断标准》第3版(CCMD-3)抑郁症诊断标准的青少年患者进行为期8w的开放性米氮平治疗,以汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI)为评估临床疗效的工具。 结果31例患者全部完成研究,所用米氮平的平均剂量为28.8mg·d-1,在治疗结束时,HAMD和CGI得分较治疗前明显改善。副反应主要为过度镇静。 结论 米氮平治疗青少年抑郁症安全、有效。     

Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain

This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. Findings revealed a significantly higher percentage of adolescents with chronic pain reporting symptoms of insomnia (54.2%) compared to healthy adolescents (19.6%), p < .001. Youth with chronic pain also reported higher cognitive and somatic arousal at bedtime, and lower sleep quality compared to the healthy cohort. In a logistic regression, two factors emerged as significant predictors of insomnia, having chronic pain (OR = 6.09) and higher levels of cognitive pre-sleep arousal (OR = 1.24). Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.     

The associations between living conditions,demography, and the ‘impact of cancer’ scale in tumor-free cancer survivors: a NOCWO study

Goals of work The “impact of cancer” scale (IOC) is a new questionnaire that explores attitudes in the physical, psychological, social, and spiritual/existential domains in cancer survivors. This study explores the associations between demography, living conditions (LCs), and the IOC dimensions in disease-free Norwegian survivors who have been treated for breast, prostate, or testicular cancer. Materials and methods A questionnaire covering demography, LCs, and the IOC was mailed to 852 cancer survivors; 459 (54%) participated. A living condition index (LCI) was calculated based on self-reported education, employment, annual income, health, housing expenditures, and social participation. Main results Survivors with a low LCI level viewed their situation significantly worse on four of five negative IOC dimensions than those with high LCI level. No significant LCI-related differences were observed for the mean scores of positive IOC dimensions. Significant associations were observed between gender, health status, employment, and five to six IOC dimensions. LCs were more often associated with the negative IOC dimensions than the positive ones. Conclusions The significant associations between LCs and dimensions of the IOC in tumor-free cancer survivors show that LCs should be considered when health care professionals assist cancer survivors in dealing with the impact the cancer experience had on their lives.